Draft Research Plan

Draft Research Plan for Healthy Weight and Weight Gain During Pregnancy: Counseling

This opportunity for public comment expired on May 23, 2018 at 8:00 PM EST

Note: This is a Draft Research Plan. This draft is distributed solely for the purpose of receiving public input. It has not been disseminated otherwise by the USPSTF.
The final Research Plan will be used to guide a systematic review of the evidence by researchers at an Evidence-based Practice Center. The resulting Evidence Review will form the basis of the USPSTF Recommendation Statement on this topic.

Recommendations made by the USPSTF are independent of the U.S. government.
They should not be construed as an official position of the Agency for Healthcare
Research and Quality or the U.S. Department of Health and Human Services.

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Draft: Proposed Analytic Framework

Abbreviations: BMI=body mass index; GWG=gestational weight gain.

Draft: Proposed Key Questions to Be Systematically Reviewed

1. a. Do interventions to limit excess gestational weight gain lead to improved health outcomes among pregnant women and their infants?
b. Do interventions to reduce prepregnancy weight in women who are overweight or obese lead to improved health outcomes among women who become pregnant and their infants?
c. Does the effectiveness of these interventions differ by age, race/ethnicity, socioeconomic status, or body mass index (BMI) category?
2. a. Do interventions to limit excess gestational weight gain lead to reduced gestational weight gain, postpartum weight retention, or obesity-related adverse perinatal conditions among pregnant women and their infants?
b. Do interventions to reduce prepregnancy weight in women who are overweight or obese lead to improved weight outcomes or reduced obesity-related adverse perinatal conditions among women who become pregnant and their infants?
c. Does the effectiveness of these interventions differ by age, race/ethnicity, socioeconomic status, or BMI category?
3. a. What are the harms of interventions to limit excess gestational weight gain in pregnant women and their infants?
b. What are the harms of interventions to reduce prepregnancy weight in women or who are overweight or obese?
c. Do the harms of these interventions differ by age, race/ethnicity, socioeconomic status, or BMI category?

Draft: Proposed Contextual Questions

Contextual questions will not be systematically reviewed and are not shown in the Analytic Framework.

What is the association between gestational weight gain and adverse maternal and infant outcomes?

What is the association between high prepregnancy BMI and risk of adverse maternal and infant outcomes?

What is the association between reduction in prepregnancy weight and risk of adverse maternal and infant outcomes among women with a high prepregnancy BMI?

Draft: Proposed Research Approach

The Proposed Research Approach identifies the study characteristics and criteria that the Evidence-based Practice Center will use to search for publications and to determine whether identified studies should be included or excluded from the Evidence Review. Criteria are overarching as well as specific to each of the key questions (KQs).

Category

Included

Excluded

Populations

Pregnant women with normal and high BMI and women who are overweight or obese (defined by BMI) planning pregnancy, including adults and adolescents

Studies limited to pregnant women with gestational diabetes mellitus

Interventions

Primary care–relevant interventions that aim to limit excess gestational weight gain or reduce prepregnancy weight focusing on one or more of the following: diet, exercise, or behavioral counseling

Interventions may be delivered via face-to-face contact, telephone, print materials, or technology (e.g., computer-based, text messages) and can be delivered by numerous potential providers, including but not limited to physicians, nurses, exercise specialists, dietitians, nutritionists, and behavioral health specialists

Studies conducted in or recruited from primary care or a health care system or studies that could feasibly be implemented in or referred from primary care

Publication language

English

All other languages

Study quality

Fair or good

Poor (according to design-specific USPSTF criteria)

*Systematic reviews will be excluded from the evidence review. However, separate searches will be conducted to identify relevant systematic reviews, and the citations of all studies included in those systematic reviews will be reviewed to ensure that the database searches have captured all relevant primary studies.